If nobody wants a "death panel" fiddling with Grandma's oxygen tube, then why do people who want health care to be a more collective experience have such a history of saying old people ought to die?

The latest is a video that went viral last week of a 2007 speech from Robert Reich, one of the progressives' big-idea guys. Reich told a crowd what a candidate for president should say if he were honest.

Among the gems: "If you're very old, we're not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It's too expensive, so we're going to let you die."

Keep in mind that while Reich isn't the president, neither is he some crazy guy the Democrats keep in the attic. He was Bill Clinton's labor secretary. Barack Obama put him on the transition team. He teaches policy at Berkeley. And he's not the first one to say old people ought to jog that lonesome valley. Such ideas are in the air.

A couple of federally funded studies, published last week suggested old people are getting too much care. One counted how many nursing home residents on kidney dialysis died - not because of the dialysis, necessarily, but such treatment is costly. "We may be overestimating the benefits," said a researcher. The other study found that demented patients got less care once relatives were told they were doomed.

Researchers mean well: Why tube up seniors in their last days if it might not benefit them? But Reich was talking not of benefits but of sacrifice to save public money. And slowing the rise in how much the nation spends on health care is an explicit Obama aim.

If we're all subsidizing each other (and on every Democratic plan now floating, we will be), then soon the question won't be whether Grandma's next year is worth it to her but whether it's worth it to us.

"The problem is that there are enough people running the show who have said some human life is worth more than others," said Cynthia Jones-Nosacek, a Milwaukee family doctor who's spoken out on ethics. The cure is to say all human lives have value.

Even ones likely to end soon. Jones-Nosacek is particularly troubled by the idea of pushing patients toward their end, as in Oregon, which offers suicide pills but not necessarily chemo, or as in Britain, where patients deemed terminal now can be sedated and starved.

She's got patients with terminal diseases, and with the advent of hospice care, if "their needs are being cared for, they don't ask for death." She's had patients go on breathing tubes to overcome pneumonia and then live for happy, bonus months. The dying need to be adequately helped, not rushed.

The trouble is that we value youth, health and independence. The current discussion devalues those who lack such things. The more that thinkers say some lives are no longer worth sustaining, the more, says Jones-Nosacek, "it becomes your duty to die." People will begin seeing themselves as burdens.

Utilitarian thinking about what sort of lives we can afford to save - because under Obamacare, it'll all be one big we - is a special danger. When the government rules that certain diseases in certain kinds of people aren't worth treating, "that may not be a death panel, but it's pretty close."

None of this is conjecture. As early as the 1990s, doctors in the Netherlands were euthanizing an estimated 1,000 people a year involuntarily. The families of a quarter of Britons put on that glideway-to-death protocol weren't told.

Unless you believe Americans are somehow immune to such slovenly ethics and the public-sector cost pressures that contribute to them, you might find it worrisome that Robert Reich drew applause from his audience of very smart policy-makers who will be setting up the rules by which we'll all take care of each other. Or by which we won't.